| Immediate Care Medical Walk-in of Hazlet, PA | |
|
1376 Highway 36 Hazlet NJ 07730 | |
| (732) 264-5500 | |
| (732) 264-5554 |
| Full Name | Immediate Care Medical Walk-in of Hazlet, PA |
|---|---|
| Speciality | Clinic/Center |
| Location | 1376 Highway 36, Hazlet, New Jersey |
| Authorized Official Name and Position | Lisa M Golding-granado (OWNER) |
| Authorized Official Contact | 7322645500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Immediate Care Medical Walk-in of Hazlet, PA 1376 Highway 36 Hazlet NJ 07730 Ph: (732) 264-5500 | Immediate Care Medical Walk-in of Hazlet, PA 1376 Highway 36 Hazlet NJ 07730 Ph: (732) 264-5500 |
| NPI Number | 1245595313 |
|---|---|
| Provider Enumeration Date | 07/05/2012 |
| Last Update Date | 01/17/2013 |
| Medicare PECOS PAC ID | 0547410797 |
|---|---|
| Medicare Enrollment ID | O20121024000045 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245595313 | NPI | - | NPPES |
| 0 | Other | NJ | HORIZON BLUE CROSS AND BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (New Jersey) | Primary |
| Provider Name | John P Mcdermott |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750313466 PECOS PAC ID: 9830183904 Enrollment ID: I20040412001267 |
| Provider Name | Elaine Bacci |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003836917 PECOS PAC ID: 4183619935 Enrollment ID: I20040420000177 |
| Provider Name | Sean K Calhoun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598862617 PECOS PAC ID: 9739151770 Enrollment ID: I20040810000713 |
| Provider Name | Cynthia S Hoens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215197959 PECOS PAC ID: 7012960768 Enrollment ID: I20050223000170 |
| Provider Name | Rosalie Adox |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518983972 PECOS PAC ID: 6103897566 Enrollment ID: I20050506000532 |
| Provider Name | Sveta U Gajria |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073540373 PECOS PAC ID: 1557304748 Enrollment ID: I20050610000223 |
| Provider Name | Daniella E Adler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235177536 PECOS PAC ID: 8729980909 Enrollment ID: I20050728000114 |
| Provider Name | Timolyne Skinner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831300524 PECOS PAC ID: 3870522196 Enrollment ID: I20050915000187 |
| Provider Name | Asha Vijayakumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043389083 PECOS PAC ID: 2860415684 Enrollment ID: I20060107000033 |
| Provider Name | William a Ippolito |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396723011 PECOS PAC ID: 8123033537 Enrollment ID: I20060207000183 |
| Provider Name | Nancy Klein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508951476 PECOS PAC ID: 2062411499 Enrollment ID: I20061213000317 |
| Provider Name | Cindy Santoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861580920 PECOS PAC ID: 0840385282 Enrollment ID: I20071001000538 |
| Provider Name | Lisa M Golding-granado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538163928 PECOS PAC ID: 4183633613 Enrollment ID: I20071108000033 |
| Provider Name | Agnicha Muzeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679767198 PECOS PAC ID: 7517044761 Enrollment ID: I20080411000421 |
| Provider Name | Punam Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770617680 PECOS PAC ID: 8325131352 Enrollment ID: I20080512000306 |
| Provider Name | John a Barone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659564821 PECOS PAC ID: 4486733839 Enrollment ID: I20081212000385 |
| Provider Name | Shreni N Zinzuwadia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629233275 PECOS PAC ID: 7517022312 Enrollment ID: I20090211000261 |
| Provider Name | Sandra M Connolly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023156825 PECOS PAC ID: 1557427879 Enrollment ID: I20090311000313 |
| Provider Name | Allan Pontipiedra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548400195 PECOS PAC ID: 7517016637 Enrollment ID: I20090602000424 |
| Provider Name | Christian Dort |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255503793 PECOS PAC ID: 1658410717 Enrollment ID: I20091202000526 |
| Provider Name | Monica Gessner-glendening |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821059635 PECOS PAC ID: 3072647700 Enrollment ID: I20100817001281 |
| Provider Name | Iza M Boesler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366449795 PECOS PAC ID: 3274618053 Enrollment ID: I20101027000019 |
| Provider Name | Siddiq Faisal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780797423 PECOS PAC ID: 8426244583 Enrollment ID: I20101201000595 |
| Provider Name | Maxwell J Castor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700190501 PECOS PAC ID: 8325930365 Enrollment ID: I20110126000947 |
| Provider Name | Jeremy Dayner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922053222 PECOS PAC ID: 6901071216 Enrollment ID: I20111215000557 |
| Provider Name | Mark Waciega |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346295482 PECOS PAC ID: 9931005428 Enrollment ID: I20111220000346 |
| Provider Name | Tracy Lynn Mount |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952698565 PECOS PAC ID: 7214197045 Enrollment ID: I20120402000102 |
| Provider Name | Chizoba Isioma Okwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962777938 PECOS PAC ID: 2567623952 Enrollment ID: I20120411000554 |
| Provider Name | Christine Ibrahim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114158987 PECOS PAC ID: 1658528575 Enrollment ID: I20120829000238 |
| Provider Name | Tina Sabharwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215297981 PECOS PAC ID: 1759539943 Enrollment ID: I20120913000018 |
| Provider Name | Christine Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629313879 PECOS PAC ID: 1557513850 Enrollment ID: I20121213000295 |
| Provider Name | Krystyna Banfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730460981 PECOS PAC ID: 6507090826 Enrollment ID: I20130927000574 |
| Provider Name | Rebecca L Tyson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932549490 PECOS PAC ID: 7315172202 Enrollment ID: I20131031000437 |
| Provider Name | Michael Lowenstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629211297 PECOS PAC ID: 9335377696 Enrollment ID: I20140113000215 |
| Provider Name | Eunice Obamiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639437403 PECOS PAC ID: 1759514409 Enrollment ID: I20140502001071 |
| Provider Name | Carol Noe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477821098 PECOS PAC ID: 5597998187 Enrollment ID: I20140506001521 |
| Provider Name | Heather Goldner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801229554 PECOS PAC ID: 6103044623 Enrollment ID: I20140826000873 |
| Provider Name | Elizabeth a Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376943399 PECOS PAC ID: 7315168036 Enrollment ID: I20141022001400 |
| Provider Name | Ian B Brodrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750336475 PECOS PAC ID: 9537380027 Enrollment ID: I20141027001503 |
| Provider Name | Sagar D Naik |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912303991 PECOS PAC ID: 2365766375 Enrollment ID: I20150122002044 |
| Provider Name | Sofia T Gamidova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326481276 PECOS PAC ID: 7618119413 Enrollment ID: I20150202001484 |
| Provider Name | Vijal Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760880629 PECOS PAC ID: 3274858667 Enrollment ID: I20150205001390 |
| Provider Name | Anthony J Burdo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366834384 PECOS PAC ID: 2062732233 Enrollment ID: I20150529001178 |
| Provider Name | Ravjot S Sodhi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760863559 PECOS PAC ID: 3476868191 Enrollment ID: I20150810002427 |
| Provider Name | Abigail Aniagyei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669879813 PECOS PAC ID: 2769797513 Enrollment ID: I20150824000013 |
| Provider Name | Victoria J Avery |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710350061 PECOS PAC ID: 4789985862 Enrollment ID: I20151214002644 |
| Provider Name | Barrington a Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649642166 PECOS PAC ID: 2567763477 Enrollment ID: I20151218001075 |
| Provider Name | Pamela J Donner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811369804 PECOS PAC ID: 6406159276 Enrollment ID: I20160128001247 |
| Provider Name | Christina J David |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497120448 PECOS PAC ID: 8325342462 Enrollment ID: I20160210000085 |
| Provider Name | Tariq Mahmood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619386414 PECOS PAC ID: 6204131634 Enrollment ID: I20160223002542 |
| Provider Name | Joan D Palermo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407221435 PECOS PAC ID: 4880990266 Enrollment ID: I20160310001736 |
| Provider Name | Syceria T Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194181933 PECOS PAC ID: 9739486572 Enrollment ID: I20160323000099 |
| Provider Name | Cherry Dizon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174982979 PECOS PAC ID: 4385943232 Enrollment ID: I20160428000606 |
| Provider Name | Michelle Donohoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891159760 PECOS PAC ID: 3870882657 Enrollment ID: I20160518000537 |
| Provider Name | Olga Gonzalez-byrne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336516582 PECOS PAC ID: 1850680679 Enrollment ID: I20160518001612 |
| Provider Name | Erica Paladini |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215390893 PECOS PAC ID: 5193014520 Enrollment ID: I20160525000391 |
| Provider Name | Courtney Lauren Berhang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306204458 PECOS PAC ID: 9335431519 Enrollment ID: I20160708000235 |
| Provider Name | Christopher J Sharpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356702203 PECOS PAC ID: 1153613112 Enrollment ID: I20160712001447 |
| Provider Name | Evan M Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447426457 PECOS PAC ID: 5294029500 Enrollment ID: I20160810000088 |
| Provider Name | Brittany Mcneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952755605 PECOS PAC ID: 6002101540 Enrollment ID: I20160824000037 |
| Provider Name | Christopher a Rambaran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114471372 PECOS PAC ID: 3274820865 Enrollment ID: I20160926001309 |
| Provider Name | Karen M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881057388 PECOS PAC ID: 7113215310 Enrollment ID: I20161004000311 |
| Provider Name | Shannon M Wanless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063966323 PECOS PAC ID: 6608155783 Enrollment ID: I20161111001970 |
| Provider Name | Tiffiny Shantay Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942622915 PECOS PAC ID: 8325329188 Enrollment ID: I20170110001962 |
| Provider Name | Craig D Landzinski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598216616 PECOS PAC ID: 3870875438 Enrollment ID: I20170117001200 |
| Provider Name | Jennifer Manzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003367509 PECOS PAC ID: 9537442140 Enrollment ID: I20170206001309 |
| Provider Name | Brittany M Mauro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134670748 PECOS PAC ID: 2961785498 Enrollment ID: I20170208000501 |
| Provider Name | Shannon M Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457703431 PECOS PAC ID: 6002199031 Enrollment ID: I20170216001613 |
| Provider Name | Sandra Masino Kalinowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760929921 PECOS PAC ID: 8325323116 Enrollment ID: I20170317000352 |
| Provider Name | Pradip Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194044388 PECOS PAC ID: 5799053120 Enrollment ID: I20170607003020 |
| Provider Name | Juliane N Everest |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184921322 PECOS PAC ID: 1557546587 Enrollment ID: I20170713000881 |
| Provider Name | Jane C Clawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821534124 PECOS PAC ID: 5395016810 Enrollment ID: I20170802000692 |
| Provider Name | Danielle Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144767112 PECOS PAC ID: 2769754910 Enrollment ID: I20170823000179 |
| Provider Name | Siu-han Abate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871884007 PECOS PAC ID: 4385863331 Enrollment ID: I20171113000674 |
| Provider Name | Tammy T Scholl |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225200389 PECOS PAC ID: 2062590169 Enrollment ID: I20171117000228 |
| Provider Name | Anamaria I Sandru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427574524 PECOS PAC ID: 5193082311 Enrollment ID: I20171127000917 |
| Provider Name | Judith L Cebedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790168607 PECOS PAC ID: 2466710744 Enrollment ID: I20171214000228 |
| Provider Name | Roseanne Lynn Gazia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124538657 PECOS PAC ID: 5193083822 Enrollment ID: I20171229000143 |
| Provider Name | Mary Verrinder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760994107 PECOS PAC ID: 4981963485 Enrollment ID: I20180108002650 |
| Provider Name | Rameet K Hundle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427477785 PECOS PAC ID: 7517226251 Enrollment ID: I20180125001931 |
| Provider Name | Kendie Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922512946 PECOS PAC ID: 5698035087 Enrollment ID: I20180202001375 |
| Provider Name | Sheryl Cekot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093228363 PECOS PAC ID: 0345276333 Enrollment ID: I20180214000464 |
| Provider Name | Andrew C Konopacki |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285183350 PECOS PAC ID: 2961763339 Enrollment ID: I20180227001421 |
| Provider Name | Amanda Goncalves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649797382 PECOS PAC ID: 0547521940 Enrollment ID: I20180227002990 |
| Provider Name | Mary H Stern |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952639825 PECOS PAC ID: 6608137542 Enrollment ID: I20180309001526 |
| Provider Name | Kenisha M Mclennon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033627518 PECOS PAC ID: 2668734179 Enrollment ID: I20180321002112 |
| Provider Name | Rishita N Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831563022 PECOS PAC ID: 2466755244 Enrollment ID: I20180511001440 |
| Provider Name | Marie S Tunis-blanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407332687 PECOS PAC ID: 2769739382 Enrollment ID: I20180727000187 |
| Provider Name | Bina Brandkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891273124 PECOS PAC ID: 1658622394 Enrollment ID: I20180919003455 |
| Provider Name | Lori Ann Bravenboer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003281940 PECOS PAC ID: 4183968290 Enrollment ID: I20181130000422 |
| Provider Name | Ani Veleva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366918294 PECOS PAC ID: 3971847716 Enrollment ID: I20181204003526 |
| Provider Name | Jennifer Couso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659846566 PECOS PAC ID: 9931445194 Enrollment ID: I20190108003594 |
| Provider Name | Devin R Boothe |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952558645 PECOS PAC ID: 2466504691 Enrollment ID: I20190429000745 |
| Provider Name | Tylene L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013572320 PECOS PAC ID: 0941534598 Enrollment ID: I20190702000464 |
| Provider Name | Darlene Weckesser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538650502 PECOS PAC ID: 1658608120 Enrollment ID: I20190806002583 |
| Provider Name | Elise Mccarty |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508420514 PECOS PAC ID: 3779811088 Enrollment ID: I20190824000400 |
| Provider Name | Ann Marie M Halada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871526517 PECOS PAC ID: 9032132030 Enrollment ID: I20190903000517 |
| Provider Name | Sarah O Conway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366090375 PECOS PAC ID: 6305278482 Enrollment ID: I20191111001731 |
| Provider Name | Nikki Steidle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912425497 PECOS PAC ID: 4385076371 Enrollment ID: I20191113000151 |
| Provider Name | Hamida O Yaqoobi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053954339 PECOS PAC ID: 7214360916 Enrollment ID: I20191211001485 |
| Provider Name | Nicole L Hawley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295010429 PECOS PAC ID: 5092149005 Enrollment ID: I20191230000551 |
| Provider Name | Kenya Esther Penca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417599275 PECOS PAC ID: 5092149997 Enrollment ID: I20191231002270 |
| Provider Name | Dominika Symanski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821637547 PECOS PAC ID: 5890122600 Enrollment ID: I20200217000946 |
| Provider Name | Jennifer Cosgrove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649818881 PECOS PAC ID: 1951738491 Enrollment ID: I20200224001314 |
| Provider Name | Nicole L Barone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669019592 PECOS PAC ID: 1658708813 Enrollment ID: I20200227001771 |
| Provider Name | Ekta H Makani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689156291 PECOS PAC ID: 6002244233 Enrollment ID: I20200320002570 |
| Provider Name | Oluwatoyin T Adeyeri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770120800 PECOS PAC ID: 3779912639 Enrollment ID: I20200330000375 |
| Provider Name | Amritpal Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407496060 PECOS PAC ID: 1951732411 Enrollment ID: I20200518000255 |
| Provider Name | Browlyn Marquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063063816 PECOS PAC ID: 0244651289 Enrollment ID: I20200601000014 |
| Provider Name | Ami T Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346874245 PECOS PAC ID: 0446671150 Enrollment ID: I20200605000275 |
| Provider Name | Robyn Sanfilippo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588211346 PECOS PAC ID: 3577985753 Enrollment ID: I20200616002282 |
| Provider Name | Varun K Bhatia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255855995 PECOS PAC ID: 7113345646 Enrollment ID: I20200916000793 |
| Provider Name | Sofia Voorhees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427671585 PECOS PAC ID: 0244650588 Enrollment ID: I20201026002226 |
| Provider Name | Graciela I Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578179917 PECOS PAC ID: 1355752635 Enrollment ID: I20201117001071 |
| Provider Name | Jennifer L Fey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871051284 PECOS PAC ID: 0345652731 Enrollment ID: I20201208002448 |
| Provider Name | Naila Iqbal |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912458720 PECOS PAC ID: 3971917923 Enrollment ID: I20210202002692 |
| Provider Name | Lauren K Randolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376140905 PECOS PAC ID: 8921413097 Enrollment ID: I20210223001826 |
| Provider Name | Sijo Devasia |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366046492 PECOS PAC ID: 2365857281 Enrollment ID: I20210226000092 |
| Provider Name | Katherine Grace Dymacz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790386951 PECOS PAC ID: 0840606364 Enrollment ID: I20210309000529 |
| Provider Name | Karissa Marie Feichtl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740881895 PECOS PAC ID: 8628484094 Enrollment ID: I20210309002861 |
| Provider Name | Patricia N Okorie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851987432 PECOS PAC ID: 1759798234 Enrollment ID: I20210330000067 |
| Provider Name | Eldona Sainovski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962094995 PECOS PAC ID: 2264849769 Enrollment ID: I20210330001044 |
| Provider Name | John L Hochberg |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134280480 PECOS PAC ID: 7719395789 Enrollment ID: I20210413001784 |
| Provider Name | Tochi Amaechina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437690997 PECOS PAC ID: 8325456239 Enrollment ID: I20210414000722 |
| Provider Name | Faye Dames |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467973008 PECOS PAC ID: 3678827821 Enrollment ID: I20210415000041 |
| Provider Name | Natalia Bortell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730796681 PECOS PAC ID: 9537574173 Enrollment ID: I20210421001206 |
| Provider Name | Oladayo T Pratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457848327 PECOS PAC ID: 5496163974 Enrollment ID: I20210421003070 |
| Provider Name | Vladimir Romaniv |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073543351 PECOS PAC ID: 2668475997 Enrollment ID: I20210601000870 |
| Provider Name | Jodleen Doricent |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851920839 PECOS PAC ID: 0547660888 Enrollment ID: I20210608003477 |
| Provider Name | Neel P Sahni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720649841 PECOS PAC ID: 4688074453 Enrollment ID: I20210616000407 |
| Provider Name | Julia E Martone |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740956424 PECOS PAC ID: 0749686764 Enrollment ID: I20210831000346 |
| Provider Name | Matthew L Cammarato |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578230389 PECOS PAC ID: 8123424256 Enrollment ID: I20210915000263 |
| Provider Name | Megan K Pfeifer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346918117 PECOS PAC ID: 1355748153 Enrollment ID: I20210921003030 |
| Provider Name | Billy Shawn Burk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447221635 PECOS PAC ID: 5698994325 Enrollment ID: I20211004002844 |
| Provider Name | Andrei Lobach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457925356 PECOS PAC ID: 0648678615 Enrollment ID: I20211005001980 |
| Provider Name | Danielle F Fortini |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255006557 PECOS PAC ID: 4789082439 Enrollment ID: I20211011000216 |
| Provider Name | Anna Burzynska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558030155 PECOS PAC ID: 9436557071 Enrollment ID: I20211012000923 |
| Provider Name | Joshua Tyberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942569975 PECOS PAC ID: 1153639935 Enrollment ID: I20211019002401 |
| Provider Name | Jessica Kraemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881023786 PECOS PAC ID: 8426365834 Enrollment ID: I20211123000626 |
| Provider Name | Jessica Dobrowolski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609544097 PECOS PAC ID: 5294126223 Enrollment ID: I20211229001118 |
| Provider Name | Christine a Cottrell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497428460 PECOS PAC ID: 7315338118 Enrollment ID: I20220105002826 |
| Provider Name | Nicole J Adler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962736710 PECOS PAC ID: 2163553710 Enrollment ID: I20220201002828 |
| Provider Name | Michelle a Pinto |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568630721 PECOS PAC ID: 7012328594 Enrollment ID: I20220228000197 |
| Provider Name | Mark Gerard Havlicek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033708052 PECOS PAC ID: 4385030774 Enrollment ID: I20220412001898 |
| Provider Name | Abigail Abecasis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982352712 PECOS PAC ID: 2860889318 Enrollment ID: I20220502000573 |
| Provider Name | Charles U Eke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811450174 PECOS PAC ID: 3476934688 Enrollment ID: I20220720000041 |
| Provider Name | Jared Christopher Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578120838 PECOS PAC ID: 9931582269 Enrollment ID: I20220818001319 |
| Provider Name | Osbin Gildardo Alvarado Herrera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871159715 PECOS PAC ID: 6800279993 Enrollment ID: I20220823002285 |
| Provider Name | Rachel Pagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740944321 PECOS PAC ID: 9638553969 Enrollment ID: I20220905000132 |
| Provider Name | Kathleen Desanto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295409944 PECOS PAC ID: 6507242625 Enrollment ID: I20220927002864 |
| Provider Name | Mansi Babaria |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013645449 PECOS PAC ID: 6800262635 Enrollment ID: I20221020000120 |
| Provider Name | Neophytos Zambas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609437516 PECOS PAC ID: 0648646257 Enrollment ID: I20221024001805 |
| Provider Name | Chandni Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427776517 PECOS PAC ID: 2668840877 Enrollment ID: I20221118002496 |
| Provider Name | Catherine Filippelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588205009 PECOS PAC ID: 0840668802 Enrollment ID: I20221122002550 |
| Provider Name | Nicole Latgis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194398800 PECOS PAC ID: 4587033048 Enrollment ID: I20221206001743 |
| Provider Name | Kelly St Marie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013626936 PECOS PAC ID: 3173993631 Enrollment ID: I20221228002243 |
| Provider Name | Lauren Cohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033829148 PECOS PAC ID: 6406226315 Enrollment ID: I20230110000492 |
| Provider Name | Gursharanjit Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467011718 PECOS PAC ID: 6800267246 Enrollment ID: I20230124000645 |
| Provider Name | Shedrea Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356052666 PECOS PAC ID: 5991177735 Enrollment ID: I20230204000313 |
| Provider Name | Naasiya R Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669199972 PECOS PAC ID: 7214309541 Enrollment ID: I20230214001047 |
| Provider Name | Youna Awad |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245934298 PECOS PAC ID: 7618332628 Enrollment ID: I20230426002651 |
| Provider Name | Eric Aita |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154055499 PECOS PAC ID: 6507233731 Enrollment ID: I20230516002417 |
| Provider Name | Melissa Kotowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417675463 PECOS PAC ID: 1951769827 Enrollment ID: I20230626000637 |
| Provider Name | Mary Gole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043926439 PECOS PAC ID: 6901265065 Enrollment ID: I20230707000406 |
| Provider Name | Giselle Jimenez Caceres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245735745 PECOS PAC ID: 1850768284 Enrollment ID: I20230710000275 |
| Provider Name | Jeanette Ravelo-rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003507450 PECOS PAC ID: 0042672552 Enrollment ID: I20230816000404 |
| Provider Name | Simeon Ulep |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285322966 PECOS PAC ID: 8022462357 Enrollment ID: I20230920002882 |
| Provider Name | Malali Noori |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356022271 PECOS PAC ID: 7315391760 Enrollment ID: I20231004000166 |
| Provider Name | Nicolette B Curran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942083498 PECOS PAC ID: 0648625665 Enrollment ID: I20231011003251 |
| Provider Name | Denise Gorham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457048027 PECOS PAC ID: 8325493943 Enrollment ID: I20231017000558 |
| Provider Name | Callie Covino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952189037 PECOS PAC ID: 0345699989 Enrollment ID: I20231208000459 |
| Provider Name | Sasha Dacosta-chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568248425 PECOS PAC ID: 6204270770 Enrollment ID: I20240223000747 |
| Provider Name | Kristen Connors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720855604 PECOS PAC ID: 4486091089 Enrollment ID: I20240319000860 |
| Provider Name | Angela Silletti Cayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306529706 PECOS PAC ID: 2860839479 Enrollment ID: I20240319001132 |
| Provider Name | Sharisa Lovick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215601307 PECOS PAC ID: 0345689212 Enrollment ID: I20240412000150 |
| Provider Name | Erin Hanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376242230 PECOS PAC ID: 2163883588 Enrollment ID: I20240507000206 |
| Provider Name | Alex Pezzino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003649849 PECOS PAC ID: 9739611492 Enrollment ID: I20241018001991 |
| Provider Name | Cassaundra Mancini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619795804 PECOS PAC ID: 7810421476 Enrollment ID: I20241105004108 |
| Provider Name | Mamta S Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306691548 PECOS PAC ID: 2163956327 Enrollment ID: I20241111000953 |
| Provider Name | Francine Selvakumar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811727381 PECOS PAC ID: 4183159882 Enrollment ID: I20241118003279 |
| Provider Name | Rose Melody Cimafranca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982433199 PECOS PAC ID: 1557883956 Enrollment ID: I20250314001052 |
| Provider Name | Nedgine Brutus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629825252 PECOS PAC ID: 8628590825 Enrollment ID: I20250318000113 |
| Provider Name | Danna Emile |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528883535 PECOS PAC ID: 4587176938 Enrollment ID: I20250623002073 |
Digestive Disease Specialists of Central Jersey P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 233 Middle Rd, Suite 1, Hazlet, NJ 07730 Phone: 732-888-0411 Fax: 732-888-3909 |
Sahni Medicine and Aesthetics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 35 Village Ct, Hazlet, NJ 07730 Phone: 732-945-8800 Fax: 732-945-8900 |
Vijay Saaraswat Medical LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 648 Holmdel Rd, Hazlet, NJ 07730 Phone: 732-696-0050 Fax: 732-696-0051 |
Thomas Scuderi Md,pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 80 Hazlet Ave, Suite 10, Hazlet, NJ 07730 Phone: 732-264-0400 Fax: 732-264-1149 |
Mana Medical LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 648 Holmdel Rd, Hazlet, NJ 07730 Phone: 732-656-0050 Fax: 732-965-5438 |
NJ Osteomed PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Bethany Rd, Suite 43, Hazlet, NJ 07730 Phone: 732-888-0700 Fax: 732-888-0727 |